Saw my RO about this and am thinking about doing it now that I know that I will be on HT the rest of my life. I definitely have growth from my first time around and would like to prevent more if possible. This is is in addition to working out.
Anybody have it and regret it?
Anybody have it and happy they did?
I know its an additional risk. Both my MO and RO (obviously) think its a better option than Tamoxifin. Any insight would be appreciated.
Your RO and your MO are incorrect. There was a randomized clinical trial that proved tamoxifen is better than chest radiation. Gynecomastia developed in 34% of men treated with chest radiation, but only 8% of men taking tamoxifen:
thelancet.com/journals/lano...
Since tamoxifen is available in a patch made by a compounding pharmacy, it will not cause blood clots as pills might.
Thanks for that. It’s a subject that I may need to consider in future.
Thanks TA
TA, a question - I am currently cautiously optimistic that primary treatment will be curative, however, should there be distant mets down the road and lifetime ADT is called for, should I start tamoxifen concurrently with ADT? Or should it wait for some indication of gynecomastia developing (such as sore nipples?). And should the tamoxifen also be lifetime? Am I correct that once gynecomastia develops it can only be corrected surgically?
If recurrence is localized and salvage therapy/ADT is attempted (2-3 years), should tamoxifen be given then? Are there risk indicators that would inform whether an individual should or need not have tamoxifen?
Thanks as ever for your information sharing on this forum.
Gynecomastia is usually only an issue in men who take anti-androgen monotherapy (e.g., Casodex). Men who use ADT that shuts down T production produce so little estrogen that imbalance is seldom (there are rare exceptions) a problem.
My RO checked me.out and he is pretty sure I had growth last time. That was Lupron and Zytiga. I understand Ezna is worse but could not co firm where I got that. Once again thanks, its something to consider. Its just that I am on it for life now, the first time around there was a small chance I wouldn't be.
I think tamoxifen patches are safer.
I understand, and I appreciate you saying so. I haven't made my mind up yet.
TAWho sells the patch and what is the dosage?
My MO is not familiar with tamoxifen use and when I called the compounding pharmacies in Tucson it was not to be had.
Here are a couple of compounding pharmacies that sell transdermal tamoxifen - ask them for equivalent of 10 mg/day:
empowerpharmacy.com/drugs/t...
Many thanks.I have been using the oral dose that resolved nipple swelling and pain after using the estrogen patch to control hot flashes.
Better to bypass the first pass with a patch just like the estrogen via patch.
Thanks, but that stirs new questions. Assuming there is a cheap test for serum estrogen (like there is for T), would it make sense to screen new lifer ADT patients for E to see if they are the rare exception? Also, reframe my previous questions to patients newly starting -lutamide therapy due to castration resistance re starting Tamoxifen.
In particular, I recall an earlier post of yours citing a study where Xtandi alone worked equally or better than Xtandi + Lupron for some subset of men (iirc).
No, it doesn't help to test for E2. It matters how you react to it.
There is a serum Estradiol test and I routinely combine it with tT. It is the ratio of Estradiol to Testosterone that matters, not the absolute value. A ratio of 1/180 or less, like 1/200, or better 1/250, is ok.
Great info. So my total T is 16 and Estrodiol is 32. So my ratio is 450 as of February. I also combine T measurements with my E2. It’s been 1 year on darolutamide and lupron->Orgovyx. It’s interesting and concerning that I have to ask for estrogen every time.
If your T =16 is reported in ng/dl units, then it is obvious that you are under ADT. In such a case the E2/tT ratio isn't meaningful for you. On the other hand if it is reported in nmol/l ( ~460 ng/dl ) and your E2 = 32 (reported in pg/ml) then your ratio is 0.69% or 1/145. Not bad, but not very good either. My cutoff, as already mentioned, is 1/180, According to an old post by pjoshea a good value is 0.3% or 1/330.
I had the radiation shots immediately before starting Degarelix and am very pleased I did. It took a couple of minutes and no side effects and as I’m one of the over 60% for whom it does work no need to take tamoxifen for which I’m grateful as I have enough side effects from the ADT. It was my biggest worry and I’d take tamoxifen if needed but so far so good after 16 months ADT.
Same as Brysonal - only SE was a little tenderness for a couple months (which I had anyway from the Gynecomastia starting). All good now and not interested in taking any more drugs/meds than absolutely necessary; especially since all seem to present additional SEs of their own.
I have gyno, too.
Is the pain from gynecomastia enough to warrant more drugs or radiation? Are there treatments for just the pain like topicals? I have so many body changes from ADT (now orchiectomy) and chemo that the least of my worries is my growing tits. There was a drag party last night that a friend went to. I didn't but I would not have needed socks in my bra, just a pushup 
Tbats the sentiment I am struggling with as well but radiation works better prophylactic so gonna make my decision now.I am not sure where to get the manner :0)
what do you mean by "manner"?
Sorry didn't see it auto correct, manseer.
try a sports bra. i am sure they make them big enough for anyone? I don't need one quite yet. Still working on the painted on eyebrows and eyelashes. If I get that right I might need to get the tits more obvious.
amazon.com/Secret-Male-SMA0...
amazon.com/PUMA-Womens-Seam...
I started wearing very tight base layer under my jersey and bibs and thats worked out well. Not sure if I would like just a bra but may try one this summer when hot. I'll check out above later. I have seen some soccer players wearing a technical bra but definitely not for moobs.
I’m in the same boat !
Neither worked for me 15 years ago. Lots of breast pain and little titties on a slender guy in 6 months. I went to Coast Rica and had a double mastectomy for a couple thousand, aka "male breast reduction". 15 minute procedure with anesthesia, medical holiday, some ziplining before surgery.. American plastic surgeons wanted $15K. So, that's what worked for me. I tell my girlfriends I had a double mastectomy.
I understand if there is pain. Persistent nagging pain keeps me awake but fortunately the tits do not hurt in my case. How was Costa Rica? We are thinking of retiring there if this country gets too wacky.
Costa Rica was OK, I stayed a little hotel that hosted medical tourists. I did two day tours prior to surgery, one to the Atlantic coast and the other to the Pacific coast. Complete different climates. I'm not big on 3rd world countries in all honesty, but I felt safe and the people are friendly. I can rave about the surgery clinic and the physician, I felt top notch, and I have a lot of United States medical experience to compare. I'm slender and muscular, so I'm so grateful to not have little breasts, It was amazing how fast they grew, the radiation treatment was too late to kill the breast buds. You can't notice a thing now, the scars were at the lower edge of the areolas. This was 15 years ago, so I don't know about today. I'm grateful I can afford to live in the United States where do. I know a few people who have lived overseas and they love to fit in with ex-patriot communities where-ever they go. Good luck with everything!
Completed Radiation!
Bladder Filling for Radiation and CT/Simulation 
Time for Salvage Radiation?
Salvage radiation fears
RO Consult /Radiation or wait for Molecular Tests
